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Blog author, Solai Buchanan is an experienced Registered Dietitian and Certified Diabetes Educator with an MS from Columbia Teachers College. She specializes in treating heart disease, diabetes, hypertension, high cholesterol, polycystic ovarian syndrome,and other chronic diseases. She is a provider at a full-service cardiology practice accepting most insurance and staffed with a primary care MD, pediatrician, and cardiologist. Call: 718.894.7907. NYCC is lead by Interventional Cardiologist Sanjeev Palta, MD, FSCAI, FACC. He trained at Cornell-Columbia Presbyterian Hospital and the State University Hospital of Brooklyn. He currently is an Attending Cardiologist at New York Methodist Hospital and Maimonides Medical Center. He is also an Assistant Clinical Professor in the Department of Medicine at Mount Sinai Medical Center. Having performed over 2000 invasive cardiac procedures Dr. Palta’s patients know they are in trusted hands.

Saturday, February 27, 2016

BEANS: HEART HEALTH SUPERSTARS

While we still have some remaining cold weeks ahead of us, and the produce aisle remains a somewhat dismal scene of wilting products having traveled long and far, I wanted to put in a shout out for beans.  In study after study, beans emerge as an especially heart healthy choice. The legume family includes beans, fresh and dried peas, chickpeas, lentils, and soybeans.   Legumes are excellent sources of protein, high quality, slowly digested carbohydrates, essential micronutrients, and fiber.  Substituting legumes for foods that are high in saturated fats or refined carbohydrates is likely to lower the risk of heart disease, diabetes, and weight gain.  Here are some of the highlights of bean nutrition and heart health, and some suggestions for getting more into your diet.

Bean Nutrition: 
Micronutrients & Blood Pressure:  Beans are rich in folic acid, copper, iron, potassium, and magnesium.  Healthy intake of magnesium and potassium has been found to support healthy blood pressure. 

Antioxidants:  Beans are rich sources of anti-oxidants including flavonoids, phenolic acids, and isoflavones (especially in soy beans) that reduce inflammation, a risk factor for heart disease. 

Soluble Fiber and Plant Sterols:  Beans are one of the best food sources of soluble fiber and plant sterols Intake of these nutrients has been shown to help lower harmful blood cholesterol, another risk factor for heart disease.  Also, soluble bean fiber, by slowing down digestion and carbohydrate absorption, helps to fend off unwanted peaks and valleys in blood glucose levels.

Insoluble Fiber:  Beans also provide substantial insoluble fiber, which can keep constipation and other digestive woes away.

Good Protein Low in Fat:  Legumes contain the most protein of any vegetable and they are naturally low in fat so that when they replace high fat proteins such as rich meats in the diet, they have been associated with improved weight outcomes, better heart health, and greater longevity. 

The Gas Factor:  Beans are a feast for the healthy bacteria in your gut and have been shown to support healthier gut flora populations and reduced gut inflammation, but this also makes them gassy.  By increasing your intake gradually you can minimize gassiness.  Also, if you use the overnight soaking method of cooking, the gassiness of the beans is reduced.  When simmering the plain beans after soaking add some kombu seaweed or the Mexican herb Epazote.  These help to tenderize and increase digestibility and can be removed before using the beans in a recipe.  And, adding spices such as cumin, coriander, tumeric, or caraway when cooking bean dishes can help to counter the gassiness of beans.  Certain kinds of beans including lentils, chickpeas, aduki beans, and mung beans tend to be less gassy choices. If you still find that beans are causing a lot of gas consider taking a product such as Beano or Phazyme before a bean meal.  These types of products are generally safe and help your body digest high fiber foods such as beans. 

Preparing Beans:  You can use the canned beans or cook them from the dried.  If cooking, measure out what you will be cooking and sort through the beans to remove impurities and any that appear broken, shriveled, or darkened.  Then soak the beans overnight (you do not need to soak dried peas & lentils).  Drain and rinse several times.  Add water to cover beans by at least 1 inch and bring pot to a gentle boil until a foam forms on the top of the water.  Skim off the foam, turn the heat down to a gentle simmer, cover the beans, and cook until tender.  Always season after beans are cooked.  If buying the canned, drain and rinse the beans before using.  Look for brands that have no sodium added.


Tips for Getting More Beans in Your Diet:
·         Have a snack of fresh veggies dipped in hummus or bean dip
·         Sprinkle them on salad, cooked greens, or in sandwiches
·         Eat bean soups, chili, or baked beans
·         Mix them into into rice, pasta, or potato
·         Make casseroles that include beans
·         Snack on edamame (green soybeans) that are available as an appetizer at Japanese restaurants or in the frozen section at your grocery store
·         Opt for a vegetarian stir-fry with tofu and/or sprouted mung beans
·         Snack on dry-roasted soy nuts, edamame, or chickpeas (to make your own drain canned chickpeas, toss in olive oil and spices, and bake at 400°F for 25-30 min.)
·         Enjoy a soy- or bean-based veggie burger
·         Make a bean burrito
·         Add green peas to salads, stir-fries, and casseroles.  (These are legumes too!)


·         

CHOLESTEROL FROM EGGS NOT ASSOCIATED WITH HEART DISEASE RISK

Cholesterol is a waxy substance produced by the body which uses it to create hormones, produce bile acids for digestion, make vitamin D and maintain healthy cell walls.  In the diet, it is found in fish, chicken, meat, eggs, and dairy foods.  Advice to limit dietary cholesterol dates back 50 years but over the last 10 years recommendations have been gradually changing and now neither the Dietary Guidelines for Americans nor the American Heart Association set limitations on cholesterol intake.  It is still thought that a small percentage of persons with genes that predispose them to increased blood cholesterol will see blood cholesterol levels significantly increased by dietary intake.  However, a recent study that included a large percentage of carriers of a gene called apolipoprotein E type 4 (Apoe4) which significantly impacts cholesterol metabolism and puts carriers at higher risk for heart disease, found that even in this group heart health appeared unrelated to dietary cholesterol intake.

In this study researchers tracked for 21-years the dietary habits and heart health of 1,032 middle-aged Finnish men, one-third of which had the Apoe4 gene.  All were heart healthy at the study's start but by the end of the tracking period over 20% had experienced at least one heart attack.  Participants averaged about 400mg of daily cholesterol intake with an average intake of one egg per day.  Among the study sample as a whole as well as among Apoe E carries, the results revealed no association between egg intake or overall cholesterol intake and heart attack.  They also found no association between cholesterol intake and carotid artery thickness, a marker of ischaemic heart disease and stroke risk.

One of the reasons that cholesterol intake had been thought to be linked to heart disease is that many foods that are rich in cholesterol are also rich in unhealthy saturated fats and intake of saturated fats does significantly impact blood cholesterol and heart health.  For example, fatty meats, chicken skin, and creamy dairy are all high in both.  But, some foods such as egg yolks, shellfish, and liver are low in saturated fat but high in cholesterol.  Moderate intake of these foods does not appear to damage heart health in most individuals.  Still, researchers caution it is still unknown whether very high intake of cholesterol such as an average of three eggs daily negatively impacts heart health. There is also some data suggesting diabetics may be vulnerable to negative cardiovascular effects of high dietary cholesterol intake.
     
What to do:  When making changes to your diet, always discuss what is right for you with your care provider, but the research appears to indicate that for most individuals intake averaging about 1 egg per day is healthy.  Eggs are nutritional powerhouses -- good sources of protein, essential fats, iron, B vitamins, vitamin D, and anti-oxidants lutein, zeaxanthin.  To control blood cholesterol, recommendations to limit saturated (the fats found in meat, chicken skin, and dairy) and completely avoid trans fats (artificial fats used to manufacture baked goods, frosting, and spreads) are still in place.  Also, high intake of sugar and refined flours is emerging as another important driver of heart disease risk.  So, to control blood cholesterol avoid trans fats and limit saturated fats, sugar, and refined carbohydrates.  Instead, eat a healthy diet rich in plant-derived fats (i.e. olive oil, nuts, avocado), fruits and vegetables, whole grains, and lean proteins.    Emphasize foods high in soluble fiber such as beans, oats, barley, and gummier fruits and vegetables including avocado, okra, plums, apples, oranges, green beans, and carrots.  Control your weight, exercise regularly, and take cholesterol lowering medicine as prescribed by your provider.

Sources:
Berger S, Raman G, Vishwanathan R et al.  Dietary cholesterol and cardiovascular disease: A systematic review and meta-analysis.  American Journal of Clinical Nutrition.  2015; 102: 276-294.  First published online June 24, 2015. DOI:10.3945/ajcn.114.100305

Eckel, RH.  Eggs and beyond: is dietary cholesterol no longer important?  American Journal of Clinical Nutrition.  2015; 102: 2 235-236; First published online July 15, 2015.  DOI:10.3945/ajcn.115.116905

Virtanen J, Mursu J, Virtanen H, et al. Associations of egg and cholesterol intakes with carotid intima-media thickness and risk of incident coronary artery disease according to apolipoprotein E phenotype in men: The Kuopio Ischaemic Heart Disease Risk Factor Study. American Journal of Clinical Nutrition, 2016. DOI:10.3945/ajcn.115.122317


Adapted from articles available at:
http://www.medicaldaily.com/cholesterol-eggs-heart-health-374040
https://www.nlm.nih.gov/medlineplus/news/fullstory_157281.html
https://www.sciencedaily.com/releases/2016/02/160211083044.htm